400例唇腭裂患儿母乳喂养现况调查及影响因素分析

目的 通过问卷调查,了解唇腭裂患儿母乳喂养现状并分析影响母乳喂养的因素,以促进唇腭裂患儿的母乳喂养。方法 采用随机抽样方法,抽取1994—2017年间于上海交通大学医学院附属第九人民医院接受治疗的400例唇腭裂患儿,进行问卷调查,研究内容主要包括唇腭裂患儿母乳喂养的现状及影响母乳喂养的因素。采用SPSS 20.0软件包对数据进行处理。结果 400例唇腭裂患儿中,184例（46%）接受母乳喂养,女性患儿的母乳喂养率是男性患儿的1.868倍（95%CI：1.241~2.812）,家长接受过母乳喂养专业医疗咨询患儿的母乳喂养率是家长未接受咨询患儿的1.560倍（95%CI：1.018~2.391）,唇裂组的母乳喂养率是唇裂伴腭裂组的4.904倍（95%CI：3.028~7.943）。不同类型唇腭裂患儿之间的直接母乳喂养率、软质塑料奶瓶和硬质奶瓶使用率之间有显著差异（P<0.0001）,单侧唇裂患者的直接母乳喂养率显著高于其他唇腭裂患者,单侧唇裂伴腭裂的患者软质塑料奶瓶的使用率显著高于其他唇腭裂患者。不同季节出生的患儿,母乳喂养率之间无显著差异（P=0.1374）。结论 本组唇腭裂患儿的母乳喂养率低于全世界范围内的非唇腭裂人群,其影响因素包括性别、专业人士的医疗指导以及腭裂的存在与否。

Breastfeeding rate and related influencing factors in 400 patients with cleft lip and palate

PURPOSE: To analyze the breastfeeding rate and related influencing factors of patients with cleft lip and palate by means of questionnaire, and to provide theoretical foundation for breastfeeding promotion among patients with cleft lip and palate. Methods: Four hundred patients with cleft lip and palate were randomly chosen from the patients who were treated in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine during 1994-2017. A questionnaire focusing on breastfeeding rate and related influencing factors of patients with cleft lip and palate was applied. Statistical analysis was performed using SPSS 20.0 software package. Results: Of 400 patients with cleft lip and palate, 184 received breastfeeding which accounted for 46%. Breastfeeding rate of the female patients was 1.868 times than the male (95%CI: 1.241-2.812). Breastfeeding rate of patients whose parents received professional medical counseling of breastfeeding was 1.560 times than those patients whose parents did not receive counseling of breastfeeding (95% CI:1.018-2.391). Breastfeeding rate of cleft lip group was 4.904 times than cleft lip and palate group (95%CI: 3.028-7.943). There was significant difference between direct breastfeeding, soft plastic bottle and hard bottle in different types of cleft lip and palate (P<0.0001). Direct breastfeeding rate of patients with unilateral cleft lip was significantly higher than other types. Soft plastic bottle rate in patients with unilateral lip and palate was significantly higher than other types. There was no significant difference between breastfeeding rate of patients born in different seasons(P=0.1374). Conclusions: Breastfeeding rate in patients with cleft lip and palate is lower than the non-cleft population worldwide. The influencing factors include gender, professional medical counseling and the existence of cleft palate.